Worldwide tuberculosis epidemic ‘leaving legacy of chronic lung disease’

More than a third of patients successfully cured of tuberculosis (TB) have developed permanent lung damage, according to new research.

The study was carried out by scientists at the University of Dundee, working alongside doctors in hospitals and medical centres across India.

It suggests those cured of the bacteria with antibiotics were at risk and, in worst case scenarios, had large holes in the lungs called cavities and widening of the airways called bronchiectasis.

Researchers say the figure shows the epidemic is “leaving a legacy of chronic lung disease”.

Professor James Chalmers, GSK/British Lung Foundation professor of respiratory research at the university, is lead author of the study.

He said: “This study calls urgent attention to the problem of post-TB lung damage worldwide.

“TB is a curable condition with antibiotics and great steps forward have been made towards eliminating TB.

“But this study is a wake-up call because even if we manage to eliminate all TB worldwide tomorrow, we are going to be left with a legacy of chronic lung damage and bronchiectasis which will require better recognition and better treatment.”

Around 2.8 million people are estimated to have contracted TB in India – one quarter of all cases worldwide – with the government there pledging to eradicate the bacteria by 2025.

However the study, which recruited 2,195 patients from the country who had established bronchiectasis, warned of lasting consequences.

When patients from India were compared with patients with the same lung damage in Europe and the United States, their lung function was also found to be worse and more likely to result in being taken to hospital for infections.

Prof Chalmers added: “The lung damage we observed in patients in India, not just those with TB but also those with other previous severe infections like pneumonia, was very severe lungs that were described by their doctors as ‘destroyed’.

“These problems are preventable with earlier recognition and prevention of TB and other infections like pneumonia and the consequences are treatable.

“Public health authorities need to step up their efforts to rapidly diagnose and treat TB, otherwise we could end up in a situation where we could see one epidemic replaced with another.”

The research was published in Lancet Global Health and funded by the British Lung Foundation and the European Respiratory Society.

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